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General NPI Number Information
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NPI Number | 1457663692
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Entity Type | Individual
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Provider Name | JONATHAN BROWN D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2010
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 603 7TH ST S STE 450
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4741
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Country | US
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Telephone | 727-527-5272
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Fax |
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Provider Business Mailing Address
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Address Line | 5901 E FOWLER AVE STE 100
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-2305
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Country | US
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Telephone | 813-978-9700
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Fax | 813-558-6494
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO4485
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 5079
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License Number State | CA
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